Do-over vote needed on AHCA?

countryboy said:

I see, so you and your ilk basically won't be happy unless insurance companies are forced into losing billions and billions of dollars and ultimately being put out of business? Am I right?

Click to expand...

No. I didn't say that. Don't try to nail me down on Obamacare or Trumpcare. I'm not going to defend either. If I had to pick one it would be Obamacare with revisions. As I stated earlier I would like universal healthcare in the United States.

Risky Thicket said:

No. I didn't say that. Don't try to nail me down on Obamacare or Trumpcare. I'm not going to defend either. If I had to pick one it would be Obamacare with revisions. As I stated earlier I would like universal healthcare in the United States.

Click to expand...

If you favor O'care, you said exactly that. What "revisions" would you be talking about? Please be specific.

countryboy said:

If you favor O'care, you said exactly that. What "revisions" would you be talking about? Please be specific.

Click to expand...

Dude, I knew that question was coming next. I'm just not going to go into all that. It will lead to more questions and responses. I get that and I don't have a problem with it other than I don't want to go down that path. I'm not in love with Obamacare. It's better than Trumpcare, but I want universal healthcare. And yes, I know that also opens cans of worms about coverage and funding and taxes and private payers and all that. It's not what I want to get bogged down discussing at the present.

azgreg said:

I haven't been a big fan of it but I can see this. Let's see if this "one time market adjustment" is really a one time market adjustment.

Click to expand...

What needs to be answered is if all those health insurance companies who said they are pulling out of the ACA, actually do? In the past there have been some who made that announcement and reversed course and stayed in. More than what one would expect especially after they made the big announcement to withdraw.

Before we go off in one rash direction or another, in 2018 we need to know what counties, what portions of states, perhaps a whole state or two do not have any insurance companies in the ACA at all and those states down to one. I pretty much know or have a fair idea how those states and counties as named in numerous articles, but in the past another insurance company has stepped in to replace those leaving or the same company had a change of heart.

Then we need to come up with a projection for 2019 as to how many insurance companies are left in the ACA and how many are planning on leaving. Most of what we know today is just a projection for next year. How accurate, who knows? A lot can happen between now and the beginning of next year. The projections are that the city of Knoxville and the 15 surrounding counties will have zero insurance companies in the ACA, Iowa, the whole state won't have any either unless another insurance company steps in to replace the one Iowa now has which is leaving. Nine states at the beginning of next year will have only one insurance company. As many as a third of all U.S. counties are reported to have none or only one insurance company in the ACA. But all of that is subject to change.

I personally think we need to cool our heels and see what happens for sure. I also think the replacement is worst than the ACA itself. I and other have come to call it Obamacare lite. I am still very much anti-ACA, but am as much anti-Trumpcare if not more so than anti-ACA. Let's see how the market reacts, factors change over time and we have a lot of time until 1 January of next year for things to change. Let's not do something rash that probably will only make matters worst.

Perotista said:

Personally, I would love to see this go down in defeat or filibustered in the senate where it dies. Then let's see how the ACA fairs next year. I'm perfectly okay with giving the ACA more time as it is.

Click to expand...

azgreg said:

I haven't been a big fan of it but I can see this. Let's see if this "one time market adjustment" is really a one time market adjustment.

Click to expand...

With a competent executive, that would be a good strategy. The markets clearly had stabilized coming into 2017: everything from California's risk scores to the S&P financial analysis to the HCSC performance to the KFF analysis of trends in medical loss ratios and margins in the exchanges has told the same story. A reassuring story!

Normal, healthy market dynamics seemed to be functioning well. Continuing with a supportive HHS and perhaps even fixing the damage done by the GOP gutting the risk corridors and de-funding the cooperatives would address most of the gripes people have been expressing.

But that's not going to happen. The executive not only is incompetent, he's actively attempting to destroy the exchanges to support his absurd rhetoric.

Trump pulls Obamacare ads days ahead of enrollment deadline

Major Blow to Obamacare Mandate: IRS Won't Reject Tax Returns That Don't Answer Health Insurance Question

Trump Threatens to Withhold Payments to Insurers to Press Democrats on Health Bill

Health insurers plan big Obamacare rate hikes — and they blame Trump

Health insurers across the country are making plans to dramatically raise Obamacare premiums or exit marketplaces amid growing exasperation with the Trump administration’s erratic management, inconsistent guidance and seeming lack of understanding of basic healthcare issues. . .

The growing frustration with the Trump administration’s management — reflected in letters to state regulators and in interviews with more than two dozen senior industry and government officials nationwide — undercuts a key White House claim that Obamacare insurance marketplaces are collapsing on their own.

Instead, according to many officials, it is the Trump administration that is driving much of the current instability by refusing to commit to steps to keep markets running, such as funding aid for low-income consumers or enforcing penalties for people who go without insurance.

Click to expand...

But most health plans and state regulators interviewed for this story said the Trump administration has significantly exacerbated turmoil in the marketplaces in recent months, contributing to rising premiums and the threat of marketplaces exits.

Click to expand...

There's now a consensus in this country on expanded coverage, but there's a very real possibility that the era of trying to use markets to do this is coming to a close (thanks to, of all people, the GOP--something I wouldn't have predicted if you asked me ten years ago!).

That leaves a very narrow set of options.

Greenbeard said:

With a competent executive, that would be a good strategy. The markets clearly had stabilized coming into 2017: everything from California's risk scores to the S&P financial analysis to the HCSC performance to the KFF analysis of trends in medical loss ratios and margins in the exchanges has told the same story. A reassuring story!

Normal, healthy market dynamics seemed to be functioning well. Continuing with a supportive HHS and perhaps even fixing the damage done by the GOP gutting the risk corridors and de-funding the cooperatives would address most of the gripes people have been expressing.

But that's not going to happen. The executive not only is incompetent, he's actively attempting to destroy the exchanges to support his absurd rhetoric.

Trump pulls Obamacare ads days ahead of enrollment deadline

Major Blow to Obamacare Mandate: IRS Won't Reject Tax Returns That Don't Answer Health Insurance Question

Trump Threatens to Withhold Payments to Insurers to Press Democrats on Health Bill

Health insurers plan big Obamacare rate hikes — and they blame Trump




There's now a consensus in this country on expanded coverage, but there's a very real possibility that the era of trying to use markets to do this is coming to a close (thanks to, of all people, the GOP--something I wouldn't have predicted if you asked me ten years ago!).

That leaves a very narrow set of options.

Click to expand...

There's been rumors afloat ever since the ACA was first passed that it was designed to fail and thus leading to government run healthcare. That may or may not be. But I will agree that it is coming.

Perotista said:

There's been rumors afloat ever since the ACA was first passed that it was designed to fail and thus leading to government run healthcare.

Click to expand...

If it was designed to fail, the GOP would not need to have spent years aggressively sabotaging it. Are they secretly pushing for "government-run health care"? That's the only conspiracy theory that fits the facts at this point.

Greenbeard said:

If it was designed to fail, the GOP would not need to have spent years aggressively sabotaging it. Are they secretly pushing for "government-run health care"? That's the only conspiracy theory that fits the facts at this point.

Click to expand...

You and me look at things completely different when it comes to the ACA. It is my opinion the Democrats rushed the ACA through congress long before it was ready, flaws and all. I think they knew there were tons of flaws in it, but wanted it passed ASAP. I also think the Democrats thought they had plenty of time to fix those flaws as time goes by. They never dreamed of losing 63 seats in House that November of 2010.

The Democrats knew when they passed it they wouldn't get one bit or one iota of help from the Republicans. They were on their own. The Republicans didn't have to do a darn thing, they haven't unless you count this attempt at Obamacare lite to replace the ACA. Not doing anything isn't sabotaging when everyone knew the Republicans weren't about to. That was a gamble the Democrats took. Losing the House in 2010 was the Democrat's own doings going against the wishes and wants of the majority of Americans. That was their call, as is/was the ACA.

If the ACA survives, it survives. If it doesn't, it don't. Expecting help from the Republicans which everyone knew where they stood from the beginning is like Napoleon expecting help from the Duke of Wellington to prevent his defeat at the battle of Waterloo. Napoleon was on his own and so too were the Democrats when they went alone to pass the ACA.

Perotista said:

The Republicans didn't have to do a darn thing, they haven't unless you count this attempt at Obamacare lite to replace the ACA. Not doing anything isn't sabotaging when everyone knew the Republicans weren't about to.

Click to expand...

Of course they did. At the federal level they broke the risk corridor program (this is literally Marco Rubio's only policy "achievement" in public life), which is why most of the insurer exits to date have occurred and they de-funded the nonprofit co-op insurers, again depriving numerous markets of real competition. If you don't have an insurer in your market, thank a Republican.

At the state level the intentional screw-ups vary from place to place. Look at Tennessee's leaders: they siphoned off the healthy into medically underwritten Tennessee Farm Bureau plans. Now their individual market is skewed and unattractive to sellers--I guess they showed the Democrats!

The GOP has been actively attempting to undermine the ACA for years and in some places they've succeeded--disproportionately red states, oddly enough.

countryboy said:

Insurance companies have lost billions on O'Bamacare. How exactly is that "covering insurance companies"?

Click to expand...

For some reason, I do not accept your claim -- Making a killing under Obamacare: The ACA gets blamed for rising premiums, while insurance companies are reaping massive profits

Then there are the share prices which are usually viewed as showing a company's economic health:
United Health Group -- May 2016 $130.42 today $172.85
Aetna -- May 19 2016 $110 today $142 Aetna's the company which has a problem with truth Judge: Aetna lied about quitting Obamacare
Anthem May 19 2016 $133 today $178
WellCare May 19 2016 S94 today $171

Greenbeard said:

Of course they did. At the federal level they broke the risk corridor program (this is literally Marco Rubio's only policy "achievement" in public life), which is why most of the insurer exits to date have occurred and they de-funded the nonprofit co-op insurers, again depriving numerous markets of real competition. If you don't have an insurer in your market, thank a Republican.

At the state level the intentional screw-ups vary from place to place. Look at Tennessee's leaders: they siphoned off the healthy into medically underwritten Tennessee Farm Bureau plans. Now their individual market is skewed and unattractive to sellers--I guess they showed the Democrats!

The GOP has been actively attempting to undermine the ACA for years and in some places they've succeeded--disproportionately red states, oddly enough.

Click to expand...

Believe as you will. But when one party decides to go it alone, it shouldn't expect help to save itself from itself. Just as with Trumpcare/Obamacare lite and tax cuts, solely Republican ideas and I would bet Democrats vote against these things enmass. If something goes wrong with them, expecting Democrats to rescue them when they did these things by themselves is idiocy. The American people as a whole wasn't ready for the ACA in 2009 and 2010. It took them completely out of their comfort zone. Just like today, most Americans aren't ready to Trumpcare. Good, bad or indifferent, people have gotten use to the ACA and repeal and replace, at least at this time is once again taking the people out of their comfort zone. They will retaliate just like they did in November of 2010.

Most folks like little steps at a time, not huge gigantic leaps. If one is going to take a gigantic leap it take years of preparation as was the case with Medicare. First devised under Truman and finally passed under LBJ. If one is going to take people out of their comfort zone with a massive legislation change, one better make sure the people are with you and it takes time to ensure that.